The homelessness problem...

I took this picture a couple years ago of an empty "camp out" under a bridge where someone had been sleeping. I worked at the shelter last night, in the actual shelter not the drunk tank or detox and had some interesting conversations with a coworker about how, in a nation as rich as Canada, people could live like this. We of course didn't come to any conclusions, but I realized how much my perspective has shifted in the past few years.

Something I have been reminded about time and time again over the past year is choices. We all make choices, each and every day, and the choices we make have a HUGE outcome on our lives. It is fine and well for us to say that homelessness is horrible, and it is, but yesterday I spoke with someone who despite having been given a house, chose to stay at the shelter because that is where he felt connection and a sense of "home". Choices.

Last night I had multiple people beg me for food. See here's the thing though, we give out food right when the shelter opens, if you come later then that, no food, because once it's gone, it's gone. So, if you have spent the day/evening drinking rather than taking advantage of the abundance of free food in the city, I don't necessarily feel sorry for you. Choices.

Now, the above being said, I also recognize that once you're on the street, the choices aren't that easy. Addictions aren't exactly easy to break. To use an example from my life, the fact that I'm overweight didn't stop me from eating cookies yesterday, even though I know I probably didn't need to. And that's cookies. I can't even imagine trying to come off years of hard drinking. Then of course, there's the added challenge of Fetal Alcohol Spectrum Disorders. In some cases, people's brains simply don't allow them to learn from their mistakes, so they make the same "poor" choices again and again. Mental Illness figures in, blackouts from substance use, peer pressure and involvement, low self esteem, self efficacy and little motivation for change.

So, while I will continue to advocate for funding and services for the homeless and near homeless, there is no way I can believe that is 100% someone else's fault. There are resources out there for those who seek them, there is food out there for the hungry homeless, and there are places of safety for those who need a break from life. I do truly believe there is more we can do, that the are clinical best practices we are most certainly not following, however I think I believe that there will always be homelessness, no matter what social net we put in place.

not a very happy holiday post.

It's been awhile, so I thought I'd post another update. Life continues. Mom is having surgery on Monday which will hopefully be reaaaaally good for her. I've been working on using up my holiday days (which have to be gone by March 31st) as well as my sick days (same deal) while earning extra money working at the shelter. Over all, I'm actually doing quite well and I'm feeling like things have worked themselves into a new balance.

I worked at the shelter two days this weekend. There is something SO freeing about not having a caseload and something incredibly freeing about not having voice-mail. I am in LOVE with not having voice-mail! Seriously, I too Thursday off and I came back to EIGHT new voice-mails. Seriously people, if you leave ONE voice-mail, I promise I will get back to you. When you leave me THREE, it makes me not want to call you. (That being said, I'll still call you).

I love working at the shelter. I love my counselling job too, but I really really like hanging out with the homeless. As my long time readers will remember there are a lot of good reasons why I don't work at the shelter full time, but every now and then I get nostalgic for it. There's just something so very real about it, and I feel like I am really able to impact people. That being said, in terms of measurable change, I make a far greater difference at my other job. But, measurements, smeasurements.

decisions, decisions.

My thought for today is that I either need to go back to Yoga or back to therapy. Maybe both. I'm not making a decision till after my holiday though.

stay tuned tomorrow for why I'm pissed off about the material I learned in my food handlers course and how it relates to societies treatment of some of our most vulnerable citizens.

Housing Part Four: Barriers to Safe Housing

So now that I’ve written about kinds of housing, reason people need housing, and what safe housing looks like, it’s only fitting to consider some of the barriers to safe housing.  Why, in an industrialized nation such as Canada doesn’t everyone have safe housing?? 

Numbers

The fact is, where I live, there number of people in need of safe housing simply outweigh the number of units available.  I live in a city with an extremely low vacancy rate, and that rate is spread through all levels of housing.  If we were to measure the number of people living in substandard, crowded and unsafe housing and compare it to the current vacancy rate the difference would be staggering.  There just isn’t enough housing. 

Money

When you rent an apartment, there is more to think about then just the cost of rent.  There’s also the damage deposit, and this is a big one.  Almost always, no damage deposit means no rental, and in some cases you are expected to put down first and last month’s rent as well.  This can be simply unreachable for people living on fixed incomes, and since you don’t get your last damage deposit back till you move out… Oh, and did I mention that it is impossible to rent an apartment one what our social assistance system pays for a single persons rent, let alone a safe one? 

Poor Rental History/Bad References

Once you develop a spotty rental history, it’s really hard to get away from it.  I actually had a client turned down as soon as the caretaker saw his name, he’d heard rumors about him in the area and wasn’t willing to risk it.  For someone trying to turn their life around, it can be really frustrating to get shot down for this reason.  Of course, looking at the landlord’s perspective, why risk it! 

Disability

When you have a disability, including mental health concerns, finding housing becomes even harder.  How do you find a place, which meets your unique needs, often on a fixed income?  With such a low vacancy rate, even less are assessable, and even less of those are affordable. 

Literacy/Language

Another barrier to finding safe housing is literacy and language.  What if you can’t read or speak English.  How do you go through ads, answer and ask questions etc… if you can’t follow the language.  Immigrants often have a very difficult time finding housing and often have little money, which adds to the problem. 

Discrimination

I’d love to say that I live in a country where no one cares about the colour of a person’s skin, or the fact that two men are renting a one-bedroom apartment.  But I don’t.  And the truth is, there are some groups of people who are going to be able to find housing a lot more easily then others.  For example, it took me a total of two apartment visits to find one I wanted this time.  And I got it.  Actually, I got both; it’s just that I only needed one, so I chose the one that best suited my needs.  Of course, I’m a white professional, and that does matter, even though it shouldn’t. 

 

Housing Part Two: Who needs housing?

I’m assuming that the majority of people reading this blog have some form of safe housing.  This is simply based on what I know about the demographics of those who comment.  However, I’m also going to make the assumption that at some point in our lives, all of us have had to, or will have to, look for housing.  Because the answer to who finds themselves in need of housing, is everyone.  It just happens that for some of us, it’s easier to find housing then for others. And so we’ll begin here, with situations that create that need.  This of course doesn’t cover all of them, but gives an example.

Apartments being turned into Condominiums

I don’t know what things are like in your part of the world, but where I live, apartment building after apartment building after apartment building is being bought, upgraded, turned into condos and it’s residents asked to vacate the premises.  While there are laws around timing of this, it is still a daily reality. 

Aging out

Perhaps it’s your parents telling you it’s time to find your own place, aging out of the foster care system or adolescent mental health system, perhaps you’re aging out of something else.  The point is an inevitability of life such as aging can play a huge impact on a persons need for housing. 

Separation, Divorce, Death of Spouse

When a family splits up a need for housing is often created for at least one of its members.  For example, a client of mine wound up homeless after he and his wife split up.  His wife and children stayed in their residence and he bounced from family member to family member until there was nowhere left for him. 

Lose or Change of employment/income

A person generally lives in housing for which the rent is paid by their income.  A change in income therefore can lead to a necessary change in housing.  Job loss by one member of the family, a decision to go back to school, the loss of benefits or other income bonuses can have a huge impact on the level of housing a family is able to afford. Income can also be lost due to disability, mental health concerns, long-term illness, addiction etc…

When everything goes wrong all at once

Maybe it starts with the car breaking down, then a family member becomes ill, rent increases, and then you lose your job.  Another client describes the lead up to being homeless as starting with one little thing and snowballing from there. 

Above Market Rent Increases

Where I live there is legislation governing how much rent can go up in a given year.  However, landlords can apply to increase rent over this if they can prove why they need to.  This can lead a person to no longer be able to afford their suite for no reason other then this, and it can happen to anyone. 

Accessibility

As people age, they develop the need for more assessable buildings.  Perhaps a building with an elevator instead of stairs.  Or maybe it’s a child who needs the assess ability.  Lots of reasons that you may need to look for a place with better access. 

 

Housing Part One: Types of Housing

CB’s recent post about housing inspired me to do a short series of my own on housing, from a few different perspectives and looking at different types of housing as well as the different problems facing those who are looking for and attempting to maintain housing.  For today, we’ll start by looking at the different types of housing available where I live. 

Private Owned Property

This is very basic.  You buy a house or a condo and you live in it.  This is perhaps the “ideal” for housing, and what many people aim for.  Buying property enables you to gain equity, rather then simply having your rent sucked away. While housing can still be in a bad neighbourhood, you are free to make improvements as necessary. 

Private Rental Property

Again, basic housing, a house or apartment you rent.  These of course vary in their quality and location from the lowest of the low to first class furnished apartments.  In a rental suite, you pay rent to the landlord or rental company and in turn they are supposed to do necessary repairs, maintain the building and treat you fairly.  Obviously, this does not always happen.  For the most part, the more you pay, the more you get. 

Subsidized Rental Property

This is a system in which the government subsidizes some suites in a variety of buildings and areas through private companies.  Basically, you pay a certain percentage of your income; the government covers the rest (and property owners may give a discount) and get to stay in a nicer place then you could afford on your own.  I personally think this a great system, although many people have a huge issue with putting “poor” people in with “normal” people.  When they move to a building they don’t want there to be welfare recipients or low-income earners there. 

Public Housing

This is housing run by the government.  It operates on a percentage of income; you don’t have to be on social assistance to live there.  Often these buildings are grouped together, or a large amount of row housing is in a common area creating a little “town”.  These places are some of the most dangerous places in the city, and many have a police office in one of the row houses, or if nothing else, reserved parking for the police.  It’s just expected that they’ll be needed.  Many of the buildings are totally overrun by bedbugs and mice and are in awful states of disrepair.  I’m not sure I could actually spend the night in one.  BUT some people really like the sense of community they feel living in these areas.  Often family is living nearby and neighbours become friends. 

Rooming Houses

Just as it sounds, a rooming house is a house in which you rent a room.  While some are okay, most are the kind of places I won’t go visit clients alone.  Shared bathroom, shared kitchen, little enforcement of rules.  Dirt, bugs, filth, rodents, drugs, prostitution, exploitation etc…  At some the conditions are inhumane with little running water, poor insulation and other structural problems.  The fire risk is huge, and when there’s fire, people often die. 

Hotels

Then there’s the hotel system.  Many hotels in the core area offer rent by the month.  These are ancient hotels in bad repair.  A lot of them don’t have separate bathrooms, or any kitchen facilities.  The most popular establishment is the bar on the main floor.  I remember when doing practicum, one of my clients would meet me at the door and walk me back out because he didn’t feel that I was safe walking down the hallway alone. 

Room and Board

I don’t know how to even begin to describe these places.  Picture a large house, a cook, and a whole bunch of people many of whom are extremely mentally ill.  For a person entire rent and food budget from social assistance, they can stay there and get their meals there.  Often these places are two to a room, and you don’t get to choose your own roommate, and all meals have to be served within the cook’s eight-hour shift.  Rice and frozen vegetables are often served at all meals.  Dinner’s at 4, and then there are no meals till morning. 

Group Homes

Housing for the mentally ill or the psychically disabled.  From what I’ve seen, people with an intellectual or physical disability are treated much better then those with mental illness.  Many group homes are run for profit, so the owner tries to do as much as they can with the least amount of money.  If they can find a staff person to live there and cook there, well, they’ve covered the requirement for 24 hour staffing.  Clients often have roommates, and once again, they eat a lot of rice.  They are certainly not anything resembling therapeutic. 

The Shelter System

No reserved beds.  No privacy.  Everything shared.  BUT, it’s often better staffed, cleaner, safer, more friendly, more homey, and has better food then a lot of the other options out there. 

 

Poems on the Spot

He sits on the corner near my house. 

His sign says 

Poems on the spot

It's his way of panhandling

From his wheelchair

He's a strange man

I've tried for a long time

To break down those walls

Sitting with him

At the Salvation Army

His duct tape covered jacket

Has me asking the question 

Why?

It's cheaper, he says, with a frown. 

But I know where you can get new ones, free. 

Last week he told me, the poem business 

Isn't going all that well

Maybe he's losing his uniqueness

People are too blind to see

He's hurting deep inside

Homelessness - The Soloist

the night of 18 turnaways

As a write this, the Sophie cat is high on cat nip... I'm such a drug pusher, lol.  It's a lot easier to laugh at her antics though, and encourage her to "use" then it is to deal with the human consequences of drug and alochol abuse and addiction.  A perhaps little known fact is that there is that the number of people seeking shelter changes every day and there is a definite pattern to it all.  We turn away far, far more people on the weekend then we do during the week.  More homeless on the weekend?  Not exactly, a lot of it comes down to alcohol... 

It happens like this.  While there is a definitely a poorer area in my city, there are social housing developments spread out in various areas of the city.  All of these are accessible by bus...during the day, but at night, when the buses stop running, it's a lot harder to get there.  It seems, that more people drink on the weekends.  I'm sure this is true anywhere.  While the bars and hotels on the strip are full of business everyday, on the weekends they're just nuts.  And here's the thing, the bars close after the buses stop running.  SO when last call comes and everyone's leaving, suddenly there seem to be a whole lot of people who simply have no way to get home and many of them seem to wind up on the steps of the shelter.  

When we get someone come to the door who hasn't stayed with us in a long time or stays with us only sporadically we ask them some questions, for starters, "where do you live?"  Most people tend to say "nowhere", but then comes the question, well, where did you stay last night, last week, last month, because you didn't stay here.  Most of us hate doing this, but really, we're not a crash spot for people too drunk to remember to go home... we just can't be that.  We don't have the room or the funding... 

But it's hard.  I can easily turn away 15+ people, and generally they're far too intoxicated for the sober shelters.  This is one of the things which shows me just how real addiction is.  When you're so drunk that you just have no way to get home and you're down to the point of sleeping in the shelter or on the street.  When do you say to yourself "wow, I slept in a bus shelter last night, this is out of control".  People get so mad at us too, because we're supposed to be the shelter and what good are we if all we do is turn people away.  It's hard for people to see the big picture when they're caught up in addiction, there's a sense of intitlement and a need for immediate gratification.  

None of us are sure exactly what to do about this... as I've posted about many times, when does having the shelter just become enabling, when does it allow people to continue on destructive life style paths and live of the system, who gets to judge that anyway? I hate having to judge who is more and less deserving of shelter, we're supposed to do it by "level of vulnerability" but it's not like we have a formula.  It's true though, I'll squish in a regular who I know is completely falling part far sooner then I'll squish in a younger intoxicated male who doesn't stay with us... but maybe it should be the other way, we are an "emergency" shelter after all.

none of the answers are easy, not even the process is... 

dumped on the door step

The other night a taxi stopped in front of the shelter.  This isn't all that unusual as people are always calling to get picked up from the drunk tank.  In this case though, the taxi was dropping someone off... I guessed almost immediatly what had happened, and I was right on the mark. 

We have a relationship with the downtown hospitals.  They'll call us and we'll send someone out in the van to pick up clients and drive them home or to the shelter.  They understand, for the most part, that we fill up, and with the exception of the brand new staff, understand that the shelter does not have any reserved beds even if a patient has given us as their address.  We will work with the hospital to try and find that person a place to go, and if worst comes to worst, they'll let the client spend the rest of the night in their waiting room and we'll pick them up in the morning in time for coffee.  It's not an ideal arrangement, but it works for the most part.  

Unfortunately, because of the way the hospital is divided, our shelter actually falls in the catchment zone for one of the suburban hospitals...how, I don't know, but it does.  This means, that when an ambulance picks up one of our clients from the shelter or surronding area, they generally wind up almost on the edge of the city, outside of our driving boundaries, and if the buses have stopped running for the night, with no way to get back downtown.  This particular hospital has somewhat of a relationship with us, simply by default, but not in the same way as the others.  And so, when that cab pulled up, I just knew it was going to be a person dump.  

And so, an old lady wound up on my steps, in the winter, with no jacket, no way to get anywhere, and our shelter was full.  Even though I'd turned away numerous people that night, I let her in, because really, what was I to do, the cab had driven away, and she wasn't one of our regulars who I knew could be "street smart".  It turned out, she had a house, but didn't have keys and so had no way to get in.  The hospital had given her a cab voucher to get to us, and assumed that we'd take care of the situation for them...how nice of them.  

I was pissed off.  SO, I did something I rarely do, I called up the hospital, and politely, gave them a piece of my mind...I think may have scared the poor girl in the ER, not something I'm proud of.  See the thing is, I can totally empathize with them.  This woman is a frequent flier, and there was nothing medically wrong with her.  Brought in by ambulance, she presented without her jacket and keys.  The hospital would have given her cab fare home, but despite repeated calls to her land lord, she had no way to get inside, and they were unable to reach anyone else for her to stay with.  They then sent her to the homeless shelter, thinking we could give her a place and help her out in the morning.  She also contributed to the situation by lying and saying she was a regular of ours when in truth, she was brand new and had no idea what she was getting herself into.  

I explained to the hospital that we need them to PHONE first before sending us something.  That maybe together we could work out a plan.  I explained that we fill up quickly at night and so unless they call first there is no gaurantee that a person is going to get in.  I talked to two different people, and I think I got my point across.  What I really wanted to say though was "dumping people on the doorstep of a shelter is NOT okay".  I really felt for this woman even though her lifestyle is likely what caused this situation in the first place.  And despite being medically cleared, she really did not look healthy.  

The thing is, hospitals are not homeless shelters.  They aren't set up to house clients because they have no place else to go.  The emergency room is not set up, nor should it have to be, to deal with people like this woman who present over and over and over and over and over.  I'm not sure what the answer is though.  Obviously we need some sort of a different system.  Personally, I think perhaps a lock smith might be a good assest to our emergency system.  I can't tell you how many people we house when they get locked out for the night.  Makes me double check my spare set of house keys everytime.  

just an all around sad story

This is a story about death.  This is a story about everyday life.  This is a story about the poor and the middle class.  This is a story about people struggling to get by.  This is the story of inequality, unfairness and injustice.  This is truth.  

Everyday in our society people work towards earning money to acquire things.  The nature of the earning and things varies, but in Canada at least, it's neccessary.  Even those who have no official earnings, the kind declared to the government, are generally working to gain income, small though it might be.  While many people think of the homeless as being beggars, theives and panhandlers, there is an entire underground trade system, a black market, which trades not just in weapons and drugs (as many people believe) but in the items of everyday life.  

The poorest area of my city is void of the big box stores one finds in the suburbs.  Most of the stores are tiny corners stores, almost all which are run by imigrant families.  In order for these stores to exist they have to charge more for their items and put in long hard hours just to eek out a living.  Unfortunately, some of these stores turn to less honest ways of gaining money preying on those even less fortunate then them.  

One store in particular, was famous for this, they were known on the street as being willing to buy just about anything from a person in exchange for money, mouthwash or hairspray (to drink).  When we gave out brand new winter jackets this Christmas we found out quickly the owner was buying them from the homeless and reselling them for a higher price... once we started cutting the tags off this petered out, but it continues to happen with a variety of other things.  Because it's not a pawn shop, the police don't run the same checks for stolen property and it's less regulated... and besides, it all happens under the table anyway.  

For whatever reason, the owner of this particular store couldn't handle life anymore, and so, he hung himself, in the back of his store, in the middle of the work day.  My clients were there when his wife found him, my clients cut him down, my clients comforted his wife, my clients called for help, and my clients were there when there was nothing left that could be done.  And it hit them hard.  Staff from one of the other organizations in the area came and did CPR while they waited for the ambulance.  They got a whole debrief session.  The clients who cut the rope, got nothing.  

One of my clients hasn't been the same since then.  Sober for almost three months he's started drinking again, and is now using injectable drugs.  He's in horrible shape.  He talks about the wife of the owner, how she just cried, and cried, and cried.  He was planning to draw her a picture, I don't know if he ever did though... why are there no services for him?  Why is it that staff are more important then clients.  And for the clients, this wasn't just some stranger, this man was a part of their community, someone they knew and interacted with on a daily basis.  Do people assume that these clients have seen so much that it just doesn't effect them anymore?  Because that's just not true... Why is it that we forget about the clients in the midst of a crisis?  

I've had a few conversations with the clients about this.  But my time and resources are so limited.  It's hard to have a deep conversation about death in the middle of a shelter full of people while the phones ring, the intoxicated scream and people are constantly interupting.  I've mentioned it to my boss... but still... just a sad story all around.  

standing up for yourself

Something I've been trying to encourage my clients to do lately is to speak out.  It seems like every day I'm hearing another story of injustice, and the abuse of my clients.  It bugs me, and while I can, and do, speak out about it, I think they need to as well.  I think not only is it more powerful coming from them, but I also think it can be very empowering.  

The thing is though, the group of people I work with tend to feel very powerless.  The most common thing I hear when I suggest "saying something" is "they won't believe me" and/or "no one will believe me".  And the thing is, they might just be right, infact, I can almost guarantee it.  However, I don't believe it always has to be this way.  

One of my clients this week came in with a black eye and a swollen hand.  When asked what happened, he said the police picked him up at a bar fight, and instead of charging him or hauling him off to the drunk tank they took him to a field at the edge of the city, beat him, and left him.  It's hard for us to believe stories like that.  The police are authority figures and this man is a homeless drug user.  However, I know this man, and he's very open about getting into fights.  He fully admits to the bar fight.  He states he was defending an old man the security guard through into the street, and this is the kind of man who would do that.  I don't see why he would make up the story about the police when he'll admit any other time that it was just a fight.  Anyway, he won't report it because they police involved would "just make it worse and beat him harder" and no one would listen anyway.  

Another client was groped by a security guard in a department store.  He tried to get her into a bathroom and called her many things I don't want to publish.  The usual things one says to females.  Her male partner (who also abuses her) "rescued" her and now wants to beat the security guard up.  He won't, because he fears reprecussions due to the guards status as an authority figure, but neither of them will report it because they feel no one will listen.  

I've been trying to help these people, and others see the bigger picture.  They're right, no one might listen.  Not the first time.  But what happens if every one this is happening to starts coming forward.  It might not make a difference, but it might, and then at least people could begin to feel like they are standing up for themselves.  As I've pointed out to them, nothing might change if you report it, but if 25 of you report it, over time, things may begin to change.  

I don't think we'll ever stop police from taking things into their own hands, men from assaulting women, and authority figures from abusing their power, at least not in my lifetime, but I think that standing up for truth and for justice can make a big difference.  

James goes to the hospital

It's funny, some of the homeless WAY overuse the medical system, constantly presenting to emergency services and emergency rooms.  There are others though, like James who don't get medical care until it's almost too late.  Because James' drinking is a little more controled then some of the others, he doesn't wind up passed out in the street quite as much and so he doesn't have the (sometimes daily) frequent medical care of others in his cohort.  So, when James got pnemonia, it wasn't till he was passed on in a pool of his own vomit in the back of the shelter that he started his contact with the medical system.  

The paramedics, were horrible.  I seriously, have so much respect for them, they do a crazy job, but each time they insult one of my clients or talk about them like they're stupid and just a burden on society I get more and more angry.  There's some good ones, and the first responder fire fighters are usually awesome, but the paramedics... wow, they're getting to me!  Anyway, they treated him like crap even though he was super cooperative and friendly with them.  There was no rudeness on his part, just some smiling (he loves to grin) and he did his best.  

There's a funny part to this story though.  I was talking to one of this client's good friends at the shelter and asked how he was doing.  Turns out though, somehow, none of this client's friends knew what had happened to him, infact, they were all quite worried as he'd just disappeared into thin air.  So, I made an oops with client confidentiality, assuming they knew he'd been hospitalized, but I think it'll be okay.  

Anyway, the client I was talking to was super relieved and decided he'd get the whole gang together to go visit their friend in the hospital.  These particular clients are the very, very chronically homeless.  They're the ones you see passed on in doorways and on sidewalks.  They're the ones who haven't bathed in years.  One of them wears a hood all the time, dresses all in black and has ear buds, which I discovered in one of his less intoxicated moments are to keep the voices out.  They're almost always intoxicated to some degree and well, if you didn't know them, they'd look pretty scary.  

What I laugh at, is the poor staff at the hospital as these guys come through the door.  If you or I was to visit a friend it would be one thing, but these guys are something else.  I'm so glad they're going though.  It shows the strength of the community.  Hopefully these guys don't pull a fast one though... our clients have been known to bring drinks and get their friends drunk while visiting!  When you're wearing 8 layers of clothing (you only think I'm exagerating), it's pretty easy to get stuff in.  

Actions and Consequences

When I was a child, my parents taught me that there was a consequence to each of my actions, good or bad, and often, if I did the wrong thing, they were the ones to enforce the consequence.  For example, leaving my room in a mess despite repeated warnings to clean it up might result in not being allowed to watch TV until it was clean.  And more serious for me, my mom almost took my entire collection of books away because she caught me reading after lights out one too many times.  As adults, there’s no parent standing over us handing down consequences, but that doesn’t mean they are no longer there.  Bestest bud, for example, expected the house to be clean when she house sat this week and so because I hadn’t cleaned in ages I had to spend the two days leading up to my vacation cleaning like mad trying to make a dent in months of clutter. 

 

Many people believe that the homeless are simply living out the consequences of their actions and because of that they do not need our help.  Rather, they simply need to take new actions which will have more positive consequences.  If unemployment led to loss of housing, finding yourself employment will then lead to housing.  This way of looking at things looks at things on a more macro level and is easily generalized to many different situations. 

On a micro level however we look at individuals, their situations, their actions and what the consequences of those actions are.  It can become easy for my coworkers and I to take on a parental role (often quite unintentionally) and become the one who hands out consequences.  A client does something wrong, we punish them.  Sniff in the shelter, kicked out for 24 hours for example.  One would expect this to be a deterrent, but if losing housing wasn’t enough to force someone to find employment will 24 hours outside force someone to stop sniffing?  I think that’s what gets to a lot of us.  We kick people out over and over and over and over again, and they’re mad, really mad, and yet month, or a week or even the next day, they’re doing it again. 

 

One reason for this is addiction.  Addiction is very powerful.  I didn’t really just how powerful until I started working in detox.  I hear people whose hearts are just breaking because of the horrible consequences of their addictions, who want more than anything to stop, and yet are somehow still held captive by their substance of choice.  Further, after you use drugs/alcohol for a while your brain starts to go.  You actually kill brain cells and damage parts of your brain, including your memory.  Further you may not remember what happened as you “blacked out” from drinking. 

 

Another reason is FASD and/or other brain damage.  One of the frustrating things about working with children with FASD is their inability to understand the consequences of their actions.  This is true for adults with FASD as well, only we expect adults to have mastered this concept.  No matter how many times we tell someone, they may simply not get it (one of the reasons we tend not to use sliding punishment scales in which the punishment increases each time the action occurs).

A third reason people do not seem to learn from their consequences as we expect them to is mental illness, bet that depression, anxiety, schizophrenia or anything else along the spectrum.  It’s hard to care about the consequences when you don’t exist in the same reality as the one who makes the rules.  Sometimes a person can be so depressed they just don’t care, don’t care at all.  Watching that can be scary, people with zero regard for their own lives are not only a danger to themselves but to those around them as well. 

 

So, how then do we create a safe environment for all people?  

label mania

I freely admit these days that I am addicted to coffee... not just any coffee in particular, but double-double's from Tim Hortons.  For those of you not lucky enough to live in Canada where this milk of the God's exists, that's coffee with two cream and two sugars (you can look it up, it's even in our dictionaries!)  Fortunately, I am also lucky enough to be able to afford said double-double pretty much every day of the week.  I also drink Starbucks, but it's more expensive, and quite inferior when it comes to coffee (except that Pike blend, I like that).  My clients however, are not always so lucky. 

Something I've noticed recently is the large number of my clients walking around with coffee cups from Tim Hortons.  Now often you here people panhandling who say "spare money for a cup of coffee"?  So I figured they were just actually buying coffee.  And seriously, with the way the coffee in the shelter tastes, I can totally, totally understand that.  To say the coffee in the shelter tastes bad, would be a serious, serious understatement... and since I've sampled the coffee at more then one shelter, I wouldn't be all that surprised if it tasted horrible pretty much everywhere... bleck.  

It came to my attention however that appearances are not always worth believing.  I discovered, that what many people are actually doing, is filling their cups with coffee from the shelter and reusing the same Tim Horton's cup over and over again.  Why would any one do this you ask?  Well, it actually makes a great deal of sense.  Having coffee from Tim's implies you have money.  Having money tends to imply that you're not homeless and that you are "worth something".  It's about the label and the brand name.  Just as kids like to sport the Nike shoes or whatever, these adults work on fitting in with society by carrying around their Tim Horton's coffee cups (which seriously, is a huge deal where I live).  

It's interesting when you think about it, the things people do to fit in... 

self determination

I've noticed an interesting trend since I started working at the shelter.  I suppose in reality I understood the theory of this, but I never really understood just how true it can be until I started working.  

People need to make their own decisions.  

That sounds like such a simple thing, but it is HARD when you're watching people circling the drain, so to speak.  We can encourage, provide, talk etc... but when people are ready to change, they're going to do it.  

It's like this.  We have a detox program.  Many of our regular shelter clients have gone through it time and time again.  It's easy for them to get into, and because it's in the building it's not necessarily a step out of their comfort zone.  They come in, take a break from using, sleeping in a bed and eat real food for a while and then after their ten days are up it's back to the street and the substances.  This can be a good thing, and it's an important part of harm reduction, but it can be frustrating to watch.  

The thing is though, when the clients really want to change, when they want to stop, they do.  Without any detox at all!  Yesterday one of my clients was very excited to show me that he had tremors, this showed he was in withdrawl, and he did it all on his own.  

Another example is housing.  We try very hard to encourage people to find housing, we have a special staff person who'll help them find it, we have housing resources etc...  when people want a place, they find it.  If they don't, nothing we do will help.  I think people are generally a lot more resourceful then we want to give them credit for!  

So, the lesson to be learned?  Don't beat yourself up when people won't change the way we want them to.  If it's right for them, they'll get there. 

why they stay

I tried to blog last week about how hard it is for people to leave the shelter... it didn't come across quite the way I wanted it to though.  I really shouldn't blog when I'm so tired my eyes keep closing.  So, my thoughts on why people don't leave the shelter...I'll get to empowerment later, or another day.  

1. The shelter is "safe".  

Interestingly enough, the opposite of this is why some people won't come into the shelter - they're scared and find them dangerous.  The shelter is safe because there are always people there, there are staff to take care of things and your friends are literally right beside you.  Living in a rooming house or an apartment on the other hand, who knows what's going on.  If you're lucky, there is one security guard for a building with 18 floors... most have no one.  

2. The shelter provides structure.

Again, something people don't like about shelters.  At the shelter there's a schedule and you have to follow it, you have no choice.  For people who grew up in places like residential schools and group homes, they may have always had a structured life.  Living on their own brings a lack of structure which can be overwhelming.  

3. The shelter provides. 

Most shelters provide food and clothing - at least in limited quanities.  They also provide staff who listen and pay attention (for the most part).  

4. The shelter is tolerant (at least our shelter)

This varies from place to place as every shelter has different rules.  Some shelters have little tolerance for anything, but ours tolerates pretty much anything.  While we don't allow drinking and sniffing in the building, the punishment is just a 24 hour suspension and you're allowed to come in intoxicated as long as you're quiet.  We'll put up with your unwashed body, your long hair, your talking to yourself, your parania, your lack of emotion, your mania, whatever it is, we'll deal with it.  

5.  Finding a place is hard

For me, finding an apartment is a chore, but realistically it's not that hard.  For starters, I can read, which means i can read the for rent adds.  I have ready access to a phone and voicemail so I can leave messages about viewings and have someone call me back.  I have a semi flexible budget and can afford a little leeway with my rent.  I have money in the bank for a damage deposit.  I have good references, and my parents still cosign for me if necessary.  For many people moving into lower income buildings they are required to provide first and last months rent as well as a damage deposit.  This can seem unreachable for someone on a fixed income living on the street.  Further many of the street people aren't recieving any social assistance at all and must first overcome that hurdle.  

6. Addiction

Many people on the street have serious addictions.  It's hard to give your money to rent when you know you could buy (insert your substance of choice here) with it.  Whatever we label this, it's a hard truth of a large percentage of the population in the shelter.  Further, many people get evicted time and time again for consequences of substance use making finding a place harder and harder. 

7. Mental Illness

People living on the streets have a higher then average rate of mental illness.  For those of you who've been depressed, you know how hard it is to do anything, anything at all.  Getting off your mat, going out, and looking for a place to live can seem totally unmanageable when faced with overwhelming depression or anxiety.  Then of course we have uncontroled psychotic disorders; living in another reality can mean housing doesn't figure into anything for you.  Overmedication is another problem and someone recieving large amount of Haldol (because yes, people still do take Haldol) may have trouble moving at all, let alone moving in somewhere.  

8. Family Atmosphere

Some of the people I work with have never been alone.  They've had large families, been in foster care, lived in group homes or residential schools, spent time insitutionalized and in hospitals and have never, ever, been completely alone.  It can be incredibly disconcerting to suddenly be all on your own when you've spent your entire life with other people.  However, moving in with friends can backfire too as if you've never learned to "work and play well with others" without the staff to act as referees you may find yourself in over your head. 

9. Lack of life skills

I've definitely posted about this before.  Imagine if no one ever taught you to clean a toilet, boil water, read directions, make your bed, do laundry etc... What if no one ever taught you how to mop the floor, that things need dusting, that food goes back when left on the counter.  How do you learn how to do that stuff?  And then of course there's the money thing.  When living on a fixed income budgeting and being thrifty tend to be important.  Spending all your money on the first of the month may seem like a good idea at the time, but how do you get through the rest of the month.  I definitely learned skills like this from my parents (much as I don't like to admit it) and can't imagine not having thing. 

10. Lack of decent affordable housing

Then there's this one, which becomes more political.  There is no good housing for the amount social assistance gives for rent.  Actually, there is NO housing for this, the most you can hope to get is a room in a falling down rooming house with a common bathroom, or perhaps a room in a hotel that literally holds just a bed.  Then of course there's the bed bugs, the mice etc... Many of these places are extremely dangerous besides just being completely disgusting.  I'm not sure i could walk down the hall to the bathroom in the middle of the night... There are some options in terms of government housing, but the waiting lists are 2+ years long and there are still bedbugs, and mice, and danger.  The only difference is the lone security guard sitting on a chair in the entry.  For all the shelter is gross, there are no bed bugs and it's disinfected every single day.  

and there you have it.  10 reasons that people stay in shelters, or at least in the shelter I work at.  

sick and homeless

This week seems to be healthcare week on the blog, or maybe ill health week, or something like that...  The image on the left is rhinovirus, or the common cold.  One of those things we all get, all hate, and most of us get over pretty quickly.  I've been blessed enough that I haven't had a cold yet this winter (no wait, I did, that one I had before I got strep throat...) In anycase though, whatever cold I did or didn't have is such a distant memory that I can't remember it (what a sentance).  

There are a lot of things most of us take for granted when we're sick.  Things like being able to buy ourselves some cold medicine, make some tea and curl up in a warm bed - even if we do drag ourselves to work.  We can look our symptoms up on the internet and get an idea of what's what (although this can backfire...trust me).  Most of us have friends or family who can drive us to the doctor, or the hospital if we're really sick.  People who'll help take care of us or our families if we need a little help.  Gosh, most of us know that if we've got a stomach bug we can at least have the privacy of our own bathroom to puke our guts out in.  

When your homeless, things change.  Homeless shelters are definitely NOT the place to be staying if you're sick, but for some people there are no other options.  I have a client right now who has cancer and has to have some major surgery.  She and her partner are looking for a place to live because once she gets out of the hospital recovery will take some time and she knows the shelter really isn't the best place to do it.  We try and be understanding of people's dificulties but the fact of the matter is we are only open 21 hours a day and people need to find someplace else to be during those 3 hours.  

Another thing about the shelter is how germs spread.  While we do our best to keep things clean the truth is people are still sleeping on mats side by side on the floor.  So when one person gets sick, well, everyone's getting sick.  That's one thing about the shelter, it's never quite.  There is always someone coughing, wretching, gagging etc...  One night there wasn't and I was worried and when around and checked to make sure people were breathing, fortunately it started up again.  

Recovering from being sick is a lot different when you don't have a safe comfortable place to do it and when you don't have healthy nutrious food to eat.  Illnesses seem to last longer or just never go away.  I know for some of my clients they haven't felt "healthy" in years.  

once again, a post with no answers... 

health issues and homelessness

Everyday I am amazed by the number of people who come into the drunk tank with serious health issues who are on no medications other than pain killers.  When a person is intaked we have to ask them about health issues as well as their medications so that if anything happens we have complete information to give the paramedics and we can chose to monitor them more closely if we're concerned.  

The one the bothers me the most is the number of people I work with who have untreated HIV.  Of course, there is no cure for AIDS, but in today's day and age there are effective ways of controlling it. Antiretrovirals should be assessable for everyone in Canada considering we have public heathcare and government funded prescriptions for those who cannot afford medications.  And they are, but there's a segment of the population that is totally missed.  I'm not going to blame this on the healthcare system.  Well, that's not completely true, I think there is more the healthcare system could be doing, but I also see tons of good things going on and this isn't going to turn into a rant about the heathcare system.   

Today, I'm going to write about personal responsibility.  Oh, I agree there are many barriers facing the homeless, and I will write for hours about them, but not today.  The truth is, people need to take responsibility for taking their medications.  Of course there are a variety of reasons why they don't, but seriously, if you're HIV positive, take your meds, it's really not that hard!  If you don't have meds, go to one of the MANY clinics available to you and get on some.  

One sad fact though, after talking to some people about this, one of the reasons many people don't take their meds, is because they don't care if they live or die, or they simply want to die.  Many people are so beaten down that they just don't care anymore.  You can't make someone care.  A doctor can prescribe all the meds in the world, but they can't make that person fill the prescription, and even if it's filled, they can't make them take their meds.  We can provide all the HIV education in the world, but it doesn't provide a sense of self esteem and self worth.  

Health is a lot more complicated then diagnosis and prescriptions... 

frequent caller

  One of the things we try and work on at the shelter is cutting back on the number of 911 calls and wasted emergency room visits among the homeless.  Studies of my city have shown that there is a group of homeless/mentally ill/both citizens make up an average of 1 in 7 visits to the downtown hospital and each one comes in an average of once a week; mostly for non-emergency situations.  We try and help people find other ways to deal with their situations.  

Right now though we have a client who is seriously abusing the 911 system which is of course a strain of resources and costs the public a whole ton of money.  It's one thing to call 911 because you have a real emergency, that's a good thing, that's what it's there for.  Then there are the people who call 911 for non emergencies because they have no transport to get to the hospital or don't really comprehend the non-severity of the situation.  Then there's calling 911 and making up complaints for an unknown reason, that's what this client is doing.  

The most likely reason the client is doing this, is that they need something.  The thing is, calling 911 telling them you can't breath and getting an ambulance to the hospital doesn't provide anything in the long term.  When you're hurting, and lonely, and lacking personal attention this works really well, in the short term.  You get paramedics, nurses and a doctor (or probably nurse practitioner) looking after you.  In the short term you probably get at least a bit of TLC.  Although, if this is the 5th time this week tempers may be getting shorter.  We're trying to work with the emergency call center to cut down on unnecessary ambulances, but then this client just goes to another drop in, and there are many in the area.  So what can be done?  

There's no easy answer in a situation like this.  Obviously the 911/hospital system is not the place for this client to have her needs addressed, but I'm not sure that such a place currently exists.  If group homes were actually group homes that might work, but warehousing her somewhere else really won't do any good.  I think maybe we should give her the number of a crisis line and see if she can call that sometimes instead of 911, and we should also try and pay a little attention to her.  

What will happen, is that social assistance will stop paying her ambulance bills, she'll wind up with a huge amount of debt and start getting less and less on her welfare cheque.  As this will give her less money to fund her substance abuse this may actually get her attention.  However, there are other ways of getting alcohol and again, it really doesn't address the route of her problem.  The hospital staff will get sick of her, and she may resort to more extreme measures to get the attention (or whatever it is) she needs.  

This post has no answers, only more questions...